Department of Laboratory Medicine, University of Pécs, Medical School, Pécs, Hungary.
Department of Anaesthesiology and Intensive Therapy, University of Pécs, Medical School, Pécs, Hungary.
Clin Chem Lab Med. 2018 Jul 26;56(8):1373-1382. doi: 10.1515/cclm-2017-0782.
Simultaneous determination of the two main actin scavenger proteins in sepsis has not been investigated until now. In our pilot study, we elucidated the predictive values of Gc globulin and gelsolin (GSN) in sepsis by comparing them to classic laboratory and clinical parameters.
A 5-day follow-up was performed, including 46 septic patients, 28 non-septic patients and 35 outpatients as controls. Serum Gc globulin and GSN levels were determined by automated immune turbidimetric assay on a Cobas 8000/c502 analyzer. Patients were retrospectively categorized according to the sepsis-3 definitions, and 14-day mortality was also investigated.
First-day GSN also differentiated sepsis from non-sepsis (AUC: 0.88) similarly to C-reactive protein (AUC: 0.80) but was slightly inferior to procalcitonin (PCT) (AUC: 0.98) with a cutoff value of GSN at 22.29 mg/L (sensitivity: 83.3%; specificity: 86.2%). Only first-day SOFA scores (0.88) and GSN (0.71) distinguished septic survivors from non-survivors, whereas lactate (0.99), Gc globulin (0.76) and mean arterial pressure (MAP) (0.74) discriminated septic shock from sepsis. Logistic regression analyses revealed SOFA scores and GSN being significant factors regarding 14-day mortality. First-day GSN levels were higher (p<0.05) in septic survivors than in non-survivors. Gc globulin levels remained higher (p<0.01) in sepsis when compared with septic shock during the follow-up period.
Both serum GSN and Gc globulin may have predictive values in sepsis. Considering the small sample size of our study, further measurements are needed to evaluate our results. Measurement of Gc globulin and GSN maybe useful in assessment of sepsis severity and in therapeutic decision-making.
目前尚未研究同时测定脓毒症两种主要肌动蛋白清除蛋白。在我们的初步研究中，我们通过将其与经典的实验室和临床参数进行比较，阐明了 G 球蛋白和凝溶胶蛋白（GSN）在脓毒症中的预测值。
进行了为期 5 天的随访，包括 46 例脓毒症患者、28 例非脓毒症患者和 35 例门诊患者作为对照。使用 Cobas 8000/c502 分析仪上的自动免疫比浊法测定血清 G 球蛋白和 GSN 水平。根据脓毒症-3 定义对患者进行回顾性分类，并调查了 14 天死亡率。
第 1 天 GSN 也能区分脓毒症和非脓毒症（AUC：0.88），与 C 反应蛋白（AUC：0.80）相似，但略逊于降钙素原（PCT）（AUC：0.98），GSN 的截断值为 22.29mg/L（灵敏度：83.3%；特异性：86.2%）。只有第 1 天 SOFA 评分（0.88）和 GSN（0.71）才能区分脓毒症存活者和非存活者，而乳酸（0.99）、G 球蛋白（0.76）和平均动脉压（MAP）（0.74）则能区分脓毒症休克和脓毒症。Logistic 回归分析显示，SOFA 评分和 GSN 是 14 天死亡率的重要因素。第 1 天 GSN 水平在脓毒症存活者中高于非存活者（p<0.05）。在随访期间，与脓毒症休克相比，G 球蛋白水平在脓毒症中仍保持较高水平（p<0.01）。
血清 GSN 和 G 球蛋白都可能对脓毒症有预测价值。考虑到我们研究的样本量较小，需要进一步测量以评估我们的结果。测量 G 球蛋白和 GSN 可能有助于评估脓毒症的严重程度并做出治疗决策。
